Long-term Care Insurance Denials Attorney Located in South Dakota
Long-term care insurance is designed to provide financial assistance for individuals who require extended medical care, whether in a nursing home, assisted living facility, or at home. Unfortunately, many policyholders in Rapid City, South Dakota, face unexpected and unfair denials when trying to access the benefits they rightfully deserve. At Abourezk Law, we understand how frustrating and devastating these denials can be for families who have diligently paid premiums for years, only to find their claims rejected when they need support the most.
Common Reasons for Long-Term Care Insurance Denials
Insurance companies often deny long-term care claims for various reasons. While some denials may be valid, others are unjust and rely on vague interpretations of the policy terms. Here are some of the most common reasons for denials:
- Failure to Meet Policy Requirements Long-term care insurance policies often come with strict guidelines on when benefits will be paid out. Many policies require the policyholder to need assistance with at least two or more activities of daily living (ADLs), such as bathing, dressing, eating, or mobility. If the insurer determines that the individual does not meet these criteria, even when they do, they may deny the claim.
- Pre-existing Conditions Some insurers deny claims based on pre-existing medical conditions that were not disclosed when the policy was purchased. Even if the condition does not directly relate to the need for long-term care, insurance companies may use this as a reason to deny a claim. It is crucial to review the policy’s language regarding pre-existing conditions carefully.
- Misinterpretation of Medical Records Insurance companies often rely on medical records to determine the level of care a policyholder needs. In many cases, they may interpret these records in a way that justifies a denial. This can occur if the insurance company selectively focuses on certain details or overlooks important aspects of a medical condition that support the need for long-term care.
- Lapsed Policies If premium payments are missed, even by a short period, insurers may use this as a reason to deny long-term care claims. While this can be a valid reason for denial, some policies include grace periods or other safeguards for policyholders facing financial difficulties, which should be thoroughly investigated.
Challenging a Long-Term Care Insurance Denial
If you or a loved one has had a long-term care insurance claim denied, you do not have to accept the decision without a fight. At Abourezk Law in Rapid City, South Dakota, we specialize in helping clients navigate the complex world of insurance denials. Our legal team will thoroughly investigate the reasons behind the denial and gather the necessary evidence to support your claim.
We can help you by:
- Reviewing the denial letter and policy details
- Collecting and organizing medical records and expert opinions
- Negotiating with the insurance company on your behalf
- Filing an appeal or lawsuit if necessary
Contact Abourezk Law for Help with Long-Term Care Insurance Denials
Don’t let an insurance company unfairly deny your claim for long-term care benefits. At Abourezk Law, we have extensive experience fighting against unjust insurance denials and will work tirelessly to secure the benefits you are owed. Contact us today for a consultation and learn how we can assist you in getting the care and coverage you deserve.